PANIC DISORDER
DEFINITION
Panic disorder is a condition in which a person feels sudden over-whelming fright, usually without any reasonable cause. A panic attack is generally accompanied by physical symptoms, such as a pounding heart, sweating, and rapid breathing. A person with panic disorder may have repeated panic attacks and feel constant fear as to when the next attack will occur.
DESCRIPTION
Most people experience moments of anxiety. They worry about money, their job, the future, or some other issue. But panic disorder is far more serious. It is a chronic (long-lasting), crippling condition that can have a devastating impact on a person's family, work, and social life. Panic disorder is thought to affect about one in every sixty Americans.
The first panic attack can strike a person anywhere. Suddenly, for no good reason, the person has a sense of impending doom. His or her palms begin to sweat, and the heart begins to beat wildly.
Panic Disorder: Words to Know
- Agoraphobia:
- A fear of open spaces.
- Anxiety:
- Feeling troubled, uneasy, or worried.
- Cognitive-behavioral therapy:
- A form of counseling designed to help patients change the way they think about their problems and change the way they respond to those problems.
- Neurotransmitters:
- Chemicals that help carry messages between nerve cells in the brain.
- Serotonin:
- An important neurotransmitter in the brain.
Panic attacks usually last only a few seconds or minutes. But they are terrifying. People who have experienced a panic attack begin to wonder and worry about when the next attack will occur. They will start to avoid situations that might trigger an attack. In extreme cases, patients may become so frightened that they refuse to leave their homes. This condition is known as agoraphobia (pronounced AG-uh-ruh-FO-bee-uh).
People who have untreated panic disorder are likely to have problems holding a job. They may become depressed, begin to abuse drugs, and even commit suicide.
CAUSES
The cause of panic disorder is not known. Some authorities believe that the condition is inherited. They think that patients may have unusually sensitive nervous systems that respond inappropriately to events and surroundings.
SYMPTOMS
People with panic disorder usually have their first attack in their twenties. Specialists define a panic attack as an event with any four of the following symptoms:
- Pounding, skipping, or fluttering heartbeat
- Shortness of breath or a sense of being smothered
- Dizziness or light-headedness
- Nausea or stomach problems
- Chest pains or pressure on the chest
- Choking sensation or a "lump in the throat"
- Chills or hot flashes
- Sweating
- Fear of dying
- Feelings of unreality
- Feelings of tingling or numbness
- Shaking and trembling
- Fear of losing control or going crazy
DIAGNOSIS
The first step in diagnosing panic disorder is to rule out physical disorders. Some of the symptoms described also occur with medical conditions, such as heart problems. A doctor must first confirm that the patient does not have some type of medical condition that produces these symptoms.
Once physical causes are eliminated, the patient should be seen by a mental health professional. He or she will take a personal history to learn more about the nature of the panic attacks and the patient's feelings about those attacks. They will also assess the way in which the panic attacks affect the patient's daily life.
TREATMENT
As with most mental disorders, panic disorder is treated with a combination of medication and counseling. Many experts believe that panic attacks are caused by an imbalance of neurotransmitters. Neurotransmitters are chemicals that help carry messages between nerve cells in the brain. An excess or shortage of neurotransmitters can cause a wide variety of mental disorders.
Medications prescribed for panic disorder are designed to restore the proper balance of neurotransmitters. For example, a group of drugs called
selective serotonin reuptake inhibitors (SSRIs) control the action of serotonin (pronounced sihr-uh-TOE-nun). Serotonin is one of the most important neurotransmitters in the brain.
Other medications are designed to calm patients down. These medications are called antidepressants. They can often help relieve the worst symptoms of panic disorder.
One of the most effective forms of counseling is called cognitive-behavioral therapy. The purpose of cognitive-behavioral therapy is to help patients understand the nature of their disorder. Patients are taught to recognize the symptoms of an oncoming panic attack and to learn how to respond to the attack in a reasonable way. They learn breathing exercises that help them to calm down and control the physical symptoms of panic.
Patients can also make changes in their lifestyle to reduce the risk of panic attacks. These changes include eliminating caffeine and alcohol from their diets and avoiding certain legal and illegal drugs, such as marijuana, cocaine, and amphetamines.
Alternative Treatment
Some forms of relaxation therapy may help relieve the symptoms of panic disorder. Yoga, biofeedback training, and hypnotherapy may help patients achieve a more balanced outlook on life. Some practitioners recommend certain herbs to strengthen the nervous system. These herbs include lemon balm, oat straw, passion flower, and skullcap. Hydrotherapy (water therapy) may also help patients relax. The recommended treatment is hot Epsom-salt baths with oil of lavender.
PROGNOSIS
Panic disorder rarely improves without treatment. However, a combination of medication and cognitive-behavioral therapy can reduce symptoms in up to 90 percent of patients. Unfortunately, many people with panic disorder are never diagnosed with the condition and may struggle with their symptoms for years. The disorder may become so bad that they can no longer hold a job or hold on to friends.
PREVENTION
There is no way to prevent an initial panic attack. Future attacks can be prevented or made less severe by a combination of drugs and cognitive-behavioral therapy.
FOR MORE INFORMATION
Books
Bassett, Lucinda. From Panic to Power: Proven Techniques to Calm Your Anxieties, Conquer your Fears and Put You in Control of Your Life. New York: HarperCollins, 1995.
Bemis, Judith, and Amr Barrada. Embracing the Fear: Learning to Manage Anxiety and Panic Attacks. Center City, MN: Hazelden, 1994.
Peurifoy, Reneau Z. Phobias and Panic: A Step by Step Program for Regaining Control of Your Life. New York: Warner Books, 1996.
Sheehan, Elaine. Phobias and Panic Attacks: Your Questions Answered. New York: Element, 1996.
Wilson, Robert R. Don't Panic: Taking Control of Anxiety Attacks. New York: HarperCollins, 1996.
Zuercher-White, Elke. An End to Panic: Breakthrough Techniques for Overcoming Panic Disorder. Oakland, CA: New Harbinger Publications, 1995.
Periodicals
Kram, Mark, and Melissa Meyers Gotthardt. "Night of the Living Dread." Men's Health (April 1997): pp. 68–70.
Organizations
Anxiety Disorders Association of America. 11900 Parklawn Drive, Suite 100, Rockville, MD 20852. (301) 231-9350. http://www.adaa.org.
National Alliance for the Mentally Ill. 200 N. Glebe Road, #1015, Arlington, VA 22203-3728. (800) 950-NAMI. http://www.nami.org.
National Institute of Mental Health. Panic Campaign. Rm. 15C-05, 5600 Fishers Lane, Rockville, MD 20857. (800) 64-PANIC. http://www.nimh.nih.gov.
National Mental Health Association. 1021 Prince Street, Alexandria, VA 22314-2971. (800) 969-NMHA. http://www.nmha.org.
Web sites
The Anxiety and Panic Internet Resources (tAPir). [Online] http://www.algy.com/anxiety (accessed on October 30, 1999).
The Anxiety Network International Homepage. [Online] http://www.anxietynetwork.com (accessed on October 30, 1999).
"Panic Disorder." Internet Mental Health. [Online] http://www.mentalhealth.com (accessed on October 30, 1999).